Inside the anatomy

Taking good care of your teeth means knowing a bit about their structure. The tooth is comprised of three parts:

• Crown. The crown is the visible part of the tooth that sits above the gum line and is protected by enamel.

• Root. The root comprises the lower two-thirds of the tooth and extends below the gum line where it’s anchored in position. Roots are covered in a thin layer of bone that protects the interior parts of the tooth.

• Enamel. The enamel, or the hard outer-coating of the tooth, is the strongest substance in the body, helping teeth withstand the constant pressure and abuse from daily chewing. Even though it’s amazingly strong, enamel can still stain.

The basics of discoloration

Whether that morning cup o’ joe or your genes contributed to your stained teeth, it’s important to understand the different causes of discoloration. Causes are categorized as extrinsic or intrinsic:

• Extrinsic. Extrinsic discoloration occurs when the outer layer of the tooth is stained. Here are some common causes:

  • Drinks. Dark-colored drinks are frequent offenders when it comes to extrinsic discoloration. Common culprits include coffee, red wine, cranberry juice, cola and tea.

  • Food. According to Everyday Health, certain foods — including soy sauce, blueberries, tomato sauce, popsicles and balsamic vinegar — can discolor teeth.
  • Smoking. In addition to increasing your risk of gum disease and oral cancer, cigarettes and chewing tobacco also tarnish your teeth.

  • Poor oral hygiene. Research suggests that poor oral hygiene is the most common cause of extrinsic staining. On eMedicine, A. Ross Kerr, D.D.S., M.S.D., explains that when plaque is allowed to build up on the enamel, it creates a thin film that traps substances that come into contact with the teeth. Over time, this thin film darkens and stains, making the teeth look discolored.

  Solutions. Fortunately, consistent oral hygiene and trips to the dentist for regular cleaning and polishing will help control the intensity of extrinsic stains. Also, after eating or drinking teeth-tarnishing foods, rinse your mouth with water or, better yet, brush your teeth. If you use tobacco, to avoid unattractive yellow nicotine stains, also rinse or brush after each use.

• Intrinsic. Intrinsic stains occur when the inner structure of the tooth darkens or develops a yellow tint. This discoloration is trickier to prevent, because it’s caused by factors that are normally out of our control, including:

  • Heredity. Genes are the first factor that regulates our dental color, and some people have naturally whiter teeth than others. Also, according to Medline Plus, genetic defects that affect the tooth enamel — including dentinogenesis and amelogenesis — can also cause discoloration.

  • Medication. WebMD reports that some drugs can cause discoloration, including minocycline, an antibiotic that’s prescribed for severe acne and rheumatoid arthritis, and the antibiotic tetracycline, which is also used for acne.

  • Age. When we age, our teeth naturally darken as the outer layer of enamel wears away, exposing the darker tissue towards the center of the tooth.

  • Flouride. Although essential for healthy, strong teeth, excessive exposure to fluoride as a child can cause discoloration. Fluoride is found in tap water, fluoride rinses, toothpaste and fluoride supplements.

  • Dental work. Dental materials, such as fillings and crowns, can also cause intrinsic stains.

Solutions. Intrinsic stains are tougher to tackle but can be remedied with whitening treatments including bleaching. If intrinsic stains are a concern, talk to your dentist about which options are best for you.

DIY whitening treatments

Given how easily teeth can stain, it’s no wonder that whitening products and procedures are a multi-billion dollar industry. From toothpaste and trays to gel strips and gum, whitening is easy and convenient. And many products on the market are effective. Here are several you may be interested in:

• Seven-day system. Among the first truly portable at-home treatments, GoSMILE is an effective whitening product. Developed by dentist Jonathon Levine, D.M.D., P.C., GoSMILE uses a pure hydrogen peroxide-based whitening gel to lighten the appearance of extrinsic and even mild intrinsic stains in only seven days.

• Toothpaste touch-up. Keep your smile bright in-between treatments by brushing with GoSMILE AM PM Whitening Protection Fluoride Toothpaste. Fortified with fluoride, this formula helps prevent tooth decay and strengthen tooth enamel, while safely polishing away stains.

• Brightening on the go. To touch up your teeth on the go, check out Supersmile Quikee, a pocket-sized tube that whitens teeth and freshens your breath.

Professional options

While the efficacy of at-home whitening treatments has grown by leaps and bounds in the last 10 years, for a stronger whitening treatment that removes both surface stains and deep discoloration, you’ll want to turn to your dentist.

• At the office.

  • What to expect. An in-office whitening treatment typically takes 30 to 60 minutes and may require several visits for the best results. Before the product is applied, the dentist places a protective gel on your gums or a rubber protectant to shield sensitive tissue. Along with the bleaching product, the dentist might also shine a special light or laser to boost the bleaching effect.

  • Results. In-office treatments are considered the most effective and quickest strategy for achieving a whiter smile, but keep in mind that results vary depending on factors such as age, heredity and the type of stains present. While you’ll see results after the first treatment, several visits may be needed for dramatic improvement.

  • Cost. The average cost of in-office whitening is $650, according to the Consumer Guide to Dentistry. Also, make sure you visit a doctor who uses an American Dental Association or ADA-approved bleaching system.

• Take-home trays.

  • What to expect. Custom-tailored by your dentist to fit your teeth, take-home whitening trays — similar to a mouth guard — along with their gel solutions are worn for about an hour per day or overnight. Usually the kits provide enough product for a two-week treatment.

  • Results. Containing lower concentrations of peroxide, these treatments gradually lighten your teeth. The results are better than DIY trays from the drugstore, but may not be as dramatic as in-office whitening treatments.

  • Cost. At-home whitening trays vary in cost depending on the product used by your dentist. Generally, you can expect to pay $200 to $400, although some one-size-fits all trays may cost as little as $75.

Are you an ideal candidate?

Teeth whitening isn’t for everyone. Before committing to a treatment, consider the following:

• Talk to your doctor. It’s a good idea to talk to your dentist before trying any whitening product — even at-home treatments. Individuals with serious discoloration or pitted teeth will likely need professional options. Though yellowish teeth will bleach well, brownish- or grayish-colored teeth are much harder to lighten.

• Painful side effects. Those with early signs of receding gum lines, for example, might experience a lot of pain from tooth whitening. Also, keep in mind that tooth sensitivity is a common side effect, but will usually go away after the whitening is stopped.

• No treatment is permanent. Remember that no bleaching treatment is permanent, so you’ll probably require additional touch-ups. Smoking and drinking tons of coffee will mean more frequent visits. Extend the time in-between treatments with a few simple steps:

  • Floss and brush after every meal.

  • Limit the amount of soda and coffee you drink.

  • Visit the dentist twice a year.

See also:

MD Formulations Product Review

Understanding Laser Resurfacing

Is Your Diet Aggravating Your Skin?

RoC Product Review

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